APPLY ONLINE

COVINGTON YOUTH COUNCIL ONLINE APPLICATION FORM
(*Or download the PDF version here)

Name:

Address:

Address Line 2:

City or Town:

State or Province:

Zip or Postal Code:

Phone:

Email:


Length of time at current residence:
Do you live within Covington city limits?   Yes        No
If no, do you reside within a three-mile radius of Covington city limits?    Yes        No
Will you be between the ages 15-18 at the time this term begins?   Yes        No
What school do you attend?   Kentwood        Kentlake        Home School        Other School

Community related activities or volunteer experience:

Organization Name:   Length of Service:
Organization Name:   Length of Service:
Organization Name:   Length of Service:

Skills/Special Interests/Experience related to a youth council position:


Why are you seeking this appointment?


Would any conflict of interest be created as a result of your appointment?  Yes        No

If yes, please explain:

References:
Name:   Years Known:
Address: 
Telephone:    Occupation:


Name:   Years Known:
Address:
Telephone:    Occupation:

Name:   Years Known:
Address:
Telephone:    Occupation:

Essay: Please write a short essay (minimum 250 words) stating what you want to see improve in Covington and how you have tried to make things better for you and your friends.


How did you hear about this opening?  Newspaper     School       Email      Word of Mouth      Other 

  I certify that all statements are true and correct to the best of my knowledge and may be made available for public inspection.